Home Stomatitis List of new generation non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs for systemic action Non-steroidal anti-inflammatory drugs in ampoules list

List of new generation non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs for systemic action Non-steroidal anti-inflammatory drugs in ampoules list

Anti-inflammatory drugs I

drugs that suppress inflammatory process, preventing the mobilization or transformation of arachidonic acid. To P. s. do not include drugs that can influence the inflammatory process through other mechanisms, in particular, “basic” antirheumatic drugs (gold salts, D-penicillamine, sulfasalazine), (colchicine), quinoline derivatives (chloroquine).

There are two main groups of P. s.: glucocorticosteroids and nonsteroidal anti-inflammatory drugs.

Indications for the use of glucocorticosteroids as P. s. are predominantly pathoimmune. They are widely used in the acute phase of systemic diseases connective tissue(Connective tissue), arthritis, sarcoidosis, alveolitis, non-infectious inflammatory diseases skin.

Taking into account the influence of glucocorticosteroids on many functions of the body (see Corticosteroid hormones) and the possible formation of a dependence of the course of a number of illnesses (etc.) on the regularity of use of these drugs (dangerous manifestations of withdrawal) to their prescription as P. s. treat with some caution and strive to reduce the duration of their continuous use. On the other hand, among all P. s. Glucocorticosteroids have the most pronounced anti-inflammatory effect, so a direct indication for their use is an inflammatory process that is dangerous to the life or ability of the patient (in the central nervous system, in the conduction system of the heart, in the eyes, etc.).

Side effects of glucocorticosteroids depend on their daily dose, duration of use, route of administration (local, systemic), as well as on the properties of the drug itself (severity of mineralocorticoid activity, effect on, etc.). When used locally, a local decrease in resistance to infectious agents is possible with the development of local infectious complications. With the systemic use of glucocorticosteroids, Cushing's, steroid, steroid stomach, steroid, development of osteoporosis, sodium and water retention, potassium loss, arterial, myocardial dystrophy, infectious complications(primarily tuberculosis), development of psychosis, withdrawal syndrome in a number of diseases (sharp symptoms after cessation of treatment), adrenal insufficiency (after long-term use of glucocorticosteroids).

Contraindications to the systemic use of glucocorticosteroids: tuberculosis and other infectious diseases, diabetes, (including in the postmenopausal period), stomach and duodenum, arterial hypertension, tendency to thrombosis, mental disorders, . When used locally (respiratory tract), the main contraindication is the presence of an infectious process in the same area of ​​the body.

The main forms of release of glucocorticosteroids used as P. s. are given below.

Beclamethasone- dosed (beclomet-easyhaler) and dosed for inhalation for bronchial asthma (aldecin, beclazon, beclomet, beklocort, beklofort, becotide) or for intranasal use for allergic rhinitis (beconase, nasobek) at 0.05, 0.1 and 0, 25 mg in one dose. For bronchial asthma, the daily value ranges from 0.2-0.8 mg. To prevent the development of candidiasis oral cavity and upper respiratory tract it is recommended to use oral water after each inhalation of the drug. At the beginning of treatment, hoarseness and sore throat sometimes appear, which usually disappear within the first week.

Betamethasone(celeston) - tablets 0.5 mg and solution in ampoules of 1 ml (4 mg) for intravenous, intra-articular, subconjunctival administration; depot form (“diprospan”) - solution in ampoules of 1 ml (2 mg betamethasone disodium phosphate and 5 mg slowly absorbed betamethasone dipropionate) for intramuscular and intraarticular administration.

For cutaneous use - creams and tubes under the names “Betnovate” (0.1%), “Diprolene” (0.05%), “Kuterid” (0.05%), “Celestoderm” (0.1%).

Budesonide(budesonide mite, budesonide forte, pulmicort) - dosed at 0.05 and 0.2 mg in one dose, as well as dosed powder of 0.2 mg(pulmicort turbuhaler) for inhalation for bronchial asthma (therapeutic dose 0.2-0.8 mg/day); 0.025% ointment (“apulein”) for external use for atopic dermatitis, eczema, psoriasis (apply a thin layer to the affected areas of the skin 1-2 times a day).

Hydrocortisone(solu-cortef, sopolcort N) - injection suspension 5 ml in bottles (25 mg in 1 ml), as well as solution for injection in ampoules of 1 ml (25 mg) and lyophilized powder for injection, 100 mg with the supplied solvent. Used for intravenous, intramuscular and intra-articular administration (25 mg drug, in small ones - 5 mg). For external use it is available in the form of 0.1% creams, ointments, lotions, emulsions (under the names “laticort”, “lokoid”) and 1% ointments (“Cortade”).

When administered intra-articularly, the drug can cause the development of osteoporosis and the progression of degenerative changes in the joints. Therefore, it should not be used for secondary synovitis in patients with deforming arthrosis.

Desonide(prenacid) - 0.25% solution in bottles of 10 ml(eye) and 0.25% eye ointment (10 G in a tube). A water-soluble, halogen-free glycocorticoid with a pronounced anti-inflammatory effect. Indicated for iritis, iridocyclitis, episcleritis, conjunctivitis, scaly blepharitis, chemical damage to the cornea. Drops are used during the day (1-2 drops 3-4 times a day), and eye ointment is used at night.

Dexamethasone(decdan, dexabene, dexaven, dexazone, dexamed, dexona, detazone, fortecortin, fortecortin) - tablets of 0.5, 1.5 and 4 mg; solution in ampoules of 1 ml (4 mg), 2 ml(4 or 8 mg) and 5 ml (8 mg/ml) for intramuscular or intravenous (in isotonic sodium chloride solution or 5% glucose solution) administration; 0.1% solution in bottles of 10 and 15 ml (eye drops) and 0.1% ophthalmic suspension in bottles of 10 ml. Fluorine-containing synthetic glucocorticoid with pronounced anti-inflammatory and antiallergic effects. Parenteral use of the drug during systemic therapy should not be long (no more than a week). 4-8 are prescribed orally mg 3-4 times a day.

Clobetasol(dermovate) - 0.05% cream and ointment in tubes. Used for psoriasis, eczema, discoid lupus erythematosus. Apply a thin layer to the affected areas of the skin 1-2 times a day until improvement occurs. Side effects: local skin.

Mazipredon- water-soluble synthetic derivative of prednisolone: ​​solution for injection in ampoules of 1 ml(30 pcs.) for intravenous (slow) or intramuscular injection, as well as 0.25% emulsion ointment (deperzolon) for external use for dermatitis, eczema, diaper rash, lichen planus, discoid lupus, psoriasis, otitis externa. Apply a thin layer to the skin (on the soles and palms - under compression bandages) 2-3 times a day. Avoid getting the ointment in your eyes! With long-term use, systemic side effects are possible.

Methylprednisolone(medrol, metypred, solu-medrol, urbazon) - tablets of 4, 16, 32 and 100 mg; dry matter 250 mg and 1 G in ampoules with the accompanying solvent for intravenous administration; depot forms (“depo-medrol”) - for injection in bottles of 1, 2 and 5 ml (40 mg/ml), characterized by long-term (up to 6-8 days) suppression of the activity of the hypothalamic-pituitary-adrenal system. Mainly used for systemic therapy (, systemic diseases connective tissue, leukemia, various types of shock, adrenal insufficiency, etc.). Depo-Medrol can be administered intra-articularly (20-40 mg in large joints, 4-10 mg- into small ones). Side effects are systemic.

Methylprednisolone aceponate(“advantan”) - ointment 15 G in tubes. Used for various forms of eczema. Apply to affected areas of the skin once a day. With prolonged use, erythema, skin atrophy, and acne-like elements are possible.

Mometasone- dosed aerosol (1 dose - 50 mcg) for intranasal use for allergic rhinitis (drug “Nasonex”); 0.1% cream, ointment (in tubes), lotion, used for psoriasis, atopic and other dermatitis (drug “elokom”).

Intranasal inhalation of 2 doses each 1 time per day. The ointment and cream are applied in a thin layer to the affected areas of the skin once a day; For hairy parts use lotion on the skin (a few drops rubbed in once a day). With long-term use, systemic side effects are possible.

Prednisone(apo-prednisone) - tablets of 5 and 50 mg. Clinical use is limited.

Prednisolone(decortin N, medopred, prednisol) - tablets of 5, 20, 30 and 50 mg; solution for injection in ampoules of 1 ml containing 25 or 30 mg prednisolone or 30 mg mazipredone (see above); suspension for injection in ampoules of 1 ml (25 mg); lyophilized powder in ampoules of 5 ml (25 mg); eye suspension in bottles of 10 ml (5 mg/ml); 0.5% ointment in tubes. For systemic therapy, it is used in the same cases as methylprednisolone, but in comparison it exhibits a greater mineralocorticoid effect with a more rapid development of systemic side effects.

Triamcinolone(azmacort, berlicort, kenacort, kenalog, nazacort, polcortolone, triacort, tricort, fluorocort) - 4 tablets mg; dosed aerosols for inhalation for bronchial asthma (1 dose - 0.1 mg) and for intranasal use for allergic rhinitis (1 dose - 55 mcg); solution and suspension for injection in bottles and ampoules of 1 ml(10 or 40 mg); 0.1% cream, 0.025% and 0.1% ointments for cutaneous use (in tubes); 0.1% for local application in dentistry (the drug “Kenalog Orabase”). Used for systemic and local therapy; Local use in ophthalmology is prohibited. When administered intra-articularly (in large joints 20-40 mg, in small joints - 4-10 mg) duration therapeutic effect can reach 4 weeks. and more. The drug is used orally and cutaneously 2-4 times a day.

Flumethasone(Lorindene) - 0.02% lotion. Glucocorticoid for external use. Included in combination ointments. Used for psoriasis, eczema, allergic dermatitis. Apply a thin layer to the affected areas of the skin 1-3 times a day. Avoid getting the drug in your eyes! For extensive skin lesions, it is used only for a short time.

Flunisolide(Ingacort, Sintaris) - dosed aerosols for inhalation for bronchial asthma (1 dose - 250 mcg) and for intranasal use for allergic rhinitis (1 dose - 25 mcg). Prescribed 2 times a day.

Fluocinolone(sinalar, sinaflan, flucort, flucinar) - 0.025% cream, ointment in tubes. Used in the same way as flumethasone.

Fluticasone(cutivate, flixonase, flixotide) - dosed aerosol (1 dose - 125 or 250 mcg) and powder in rotadiscs (doses: 50, 100, 250 and 500 mcg) for inhalation for bronchial asthma; dosed aqueous spray for intranasal use for allergic rhinitis. Apply 2 times a day.

Nonsteroidal anti-inflammatory drugs(NSAIDs) are substances of various chemical structures that, in addition to anti-inflammatory, also, as a rule, have analgesic and antipyretic activity. The NSAID group consists of salicylic acid derivatives ( acetyl salicylic acid, mesalazine), indole (indomethacin, sulindac), pyrazolone (phenylbutazone, clofezone), phenylacetic acid (diclofenac), propionic acid (ibuprofen, naproxen, flurbiprofen, ketoprofen), oxicam (meloxicam, piroxicam, tenoxicam) and other chemical groups (benzydamine , nabumetone, niflumic acid, etc.).

The mechanism of the anti-inflammatory action of NSAIDs is associated with their inhibition of the enzyme cyclooxygenase (COX), which is responsible for the transformation of arachidonic acid into prostacyclin and thromboxane. There are two isoforms of cyclooxygenase. COX-1 is constitutional, “useful”, participating in the formation of thromboxane A 2, prostaglandin E 2, prostacyclin. COX-2 is an “inducible” enzyme that catalyzes the synthesis of prostaglandins involved in the inflammatory process. Most NSAIDs equally inhibit COX-1 and COX-2, which leads, on the one hand, to suppression of the inflammatory process, and on the other, to a decrease in the production of protective prostaglandins, which disrupts reparative processes in the stomach and underlies the development of gastropathy. That is, the mechanism of the main action of NSAIDs also contains a mechanism for the development of their main “side” actions, which are more correctly called undesirable for their intended use as P. s.

NSAIDs are used mainly in rheumatology. Indications for their use include other systemic connective tissue diseases: acute and chronic inflammatory diseases of the joints; secondary in degenerative joint diseases; microcrystalline (chondrocalcinosis, hydroxyapatite); extra-articular rheumatism. Included complex therapy NSAIDs are also used for other inflammatory processes (adnexitis, prostatitis, cystitis, phlebitis, etc.), as well as for neuralgia, myalgia, and injuries of the musculoskeletal system. The antiplatelet properties of acetylsalicylic acid (it irreversibly inhibits cyclooxygenase; in other drugs this effect is reversible within the half-life of the drug) led to its use in cardio- and angiology for the prevention of thrombosis.

A single dose of any NSAID provides only an analgesic effect. The anti-inflammatory effect of the drug appears after 7-10 days of regular use. The anti-inflammatory effect is monitored according to clinical (reduction of swelling, pain severity) and laboratory data. If there is no effect within 10 days, the drug should be replaced with another from the NSAID group. In case of local inflammatory process (bursitis, enthesitis, moderately severe), treatment should begin with dosage forms local impact(ointments, gels) and only in the absence of effect should one resort to systemic therapy (orally, suppositories, parenterally). For patients with acute arthritis (for example, gout), parenteral administration of drugs is indicated. In case of clinically significant chronic arthritis, systemic NSAID therapy should be immediately prescribed, using empirical selection of an effective and well-tolerated drug.

All NSAIDs have comparable anti-inflammatory effects, approximately equal to those of aspirin. Group differences relate mainly to side effects not related to the action of NSAIDs.

Side effects common to all NSAIDs include, first of all, the so-called NSAID gastropathy, affecting mainly antrum stomach (erythema of the mucous membrane, hemorrhage, erosion, ulcers); possibly gastric. Other gastrointestinal side effects include constipation. Inhibition of renal cyclooxygenase can be clinically manifested by fluid retention (sometimes with arterial hypertension and heart failure), the development of acute or progression of existing renal failure, and hyperkalemia. By reducing platelet aggregation, NSAIDs can promote bleeding, including from gastrointestinal ulcers, and aggravate the course of NSAID gastropathy. Other manifestations of the side effects of NSAIDs include skin (itching, cervical dysfunction). - (more often when using indomethacin), tinnitus, visual disturbances, sometimes (, confusion,), and side effects associated with individual hypersensitivity to the drug (urticaria, angioedema).

Contraindications to the use of NSAIDs: up to 1 year (for certain drugs - up to 12 years); "aspirin"; peptic ulcer of the stomach and duodenum; renal or liver failure, edema; increased, upcoming, individual intolerance to NSAIDs in history (asthma attacks, urticaria), last trimester of pregnancy, breastfeeding.

Selected NSAID medications are listed below.

Lysine acetylsalicylate(aspizol) - powder for injection 0.9 G in bottles with the supplied solvent. Administered intramuscularly or intravenously, mainly for fever, at a dose of 0.5-1 G; daily dose - up to 2 G.

Acetylsalicylic acid(aspilite, aspirin, aspirin UPSA, acesal, acylpyrin, bufferin, Magnyl, Novandol, Plidol, Salorin, Sprit-Lime, etc.) - tablets of 100, 300, 325 and 500 mg, "effervescent tablets" 325 and 500 mg. As a P. s. prescribed 0.5-1 G 3-4 times a day (up to 3 G/day); for the prevention of thrombosis, incl. repeated myocardial infarction is used in a daily dose of 125-325 mg(preferably in 3 doses). In case of an overdose, dizziness occurs in the ears. In children, aspirin use can lead to the development of Reye's syndrome.

Benzydamine(tantum) - tablets 50 each mg; 5% gel in a tube. It has good absorption when applied to the skin; used mainly for phlebitis, thrombophlebitis, after operations on the veins of the extremities. 50 are prescribed orally mg 4 times a day; The gel is applied to the skin of the affected area and gently rubbed until absorbed (2-3 times a day).

For use in dentistry (gingivitis, glossitis, stomatitis,) and for diseases of the ENT organs (laryngitis, tonsillitis), the drug “tantum verde” is produced - lozenges of 3 mg; 0.15% solution in bottles of 120 ml and metered aerosol (1 dose - 255 mcg) for topical use.

In gynecology, the drug “tantum rose” is used - 0.1% solution for topical use, 140 ml in disposable syringes and dry substance for preparing a similar solution in bags containing 0.5 G benzydamine hydrochloride and other ingredients (up to 9.4 G).

When taken orally and the resorptive effect of a locally applied drug, side effects are possible: dry mouth, nausea, swelling, sleep disturbances, hallucinations. Contraindications: age under 12 years, pregnancy and breastfeeding, increased use of the drug.

Diclofenac(Veral, Voltaren, Votrex, Diclogen, Diclomax, Naklof, Naklofen, Ortofen, Rumafen, etc.) - tablets of 25 and 50 mg; retard tablets 75 and 100 mg; 50 each mg; capsules and retard capsules (75 and 100 mg); 2.5% solution for injection in ampoules of 3 and 5 ml(75 and 125 mg); rectal 25, 50 and 100 mg; 0.1% solution in bottles of 5 ml- eye drops (drug “naklof”); 1% gel and 2% ointment in tubes. Orally, adults are prescribed 75-150 mg/day in 3 doses (retard forms in 1-2 doses); intramuscularly - 75 mg/day (as an exception for 75 mg 2 times a day). For juvenile rheumatoid arthritis, the exact dose should not exceed 3 mg/kg. Gel and ointment (cutaneously over the affected area) are used 3-4 times a day. The drug is well tolerated; side effects are rare.

Ibuprofen(brufen, burana, ibusan, ipren, markofen, perofen, solpaflex, etc.) - tablets of 200, 400 and 600 mg; 200 tablets mg; extended-release capsules 300 each mg; 2% and 2% suspension in bottles of 100 ml and suspension in bottles of 60 and 120 ml (100 mg at 5 ml) for oral administration. The therapeutic dose in adults orally is 1200-1800 mg/day (maximum - 2400 mg/day) in 3-4 doses. The drug "Solpaflex" (long-acting) is prescribed at 300-600 mg 2 times a day. (maximum daily dose 1200 mg). Overdose may cause liver dysfunction.

Indomethacin(indobene, indomin, methindol) - tablets and dragees 25 each mg; retard tablets 75 each mg; capsules 25 and 50 mg; rectal suppositories 50 and 100 mg; solution for injection in ampoules of 1 and 2 ml(30 each mg in 1 ml); 1% gel and 5% ointment for cutaneous use in tubes. The therapeutic dose for adults orally is 75-150 mg/day (in 3 doses), maximum - 200 mg/day use 1 time per day. (at night). In case of an acute attack of gout, it is recommended to take the drug 50 mg every 3 h. In case of an overdose, severe headache and dizziness (sometimes combined with an increase), as well as nausea, disorientation, are possible. With long-term use, retino- and due to deposition of the drug in the retina and cornea are observed.

Ketoprofen(actron, ketonal, knavon, oruvel, prontoket spray) - 50 capsules mg, tablets 100 mg and retard tablets 150 and 200 mg; 5% solution (50 mg/ml) for oral administration (drops); solution for injection (50 mg/ml) in ampoules of 2 ml; lyophilized dry substance for intramuscular injection and the same for intravenous administration, 100 each mg in bottles with the supplied solvent; candles 100 each mg; 5% cream and 2.5% gel in tubes; 5% solution (50 mg/ml) for external use 50 each ml in a spray bottle. Prescribed orally at 50-100 mg 3 times a day; retard tablets - 200 mg 1 time per day. during meals or 150 mg 2 times a day; suppositories, as well as cream and gel are used 2 times a day. (at night and in the morning). 100 are administered intramuscularly mg 1-2 times a day; intravenous administration is carried out only in a hospital (in cases where intramuscular administration is not possible), in a daily dose of 100-300 mg no more than 2 days. contract.

Clofezone(perclusone) is an equimolecular compound of clofexamide and phenylbutozone in capsules, suppositories and ointment form. Lasts longer than phenylbutazone; prescribed at 200-400 mg 2-3 times a day. The drug cannot be combined with other pyrazolone derivatives.

Mezalazine(5-AGA, salosinal, salofalk), 5-aminosalicylic acid - dragees and enteric-coated tablets of 0.25 and 0.5 G; rectal suppositories 0.25 and 0.5 G; suspension for use in enemas (4 G at 60 ml) in disposable containers. Used for Crohn's disease, ulcerative colitis, irritable bowel syndrome, postoperative anastomositis, complicated hemorrhoids. In the acute phase of these diseases, 0.5-1 G 3-4 times a day, for maintenance therapy and prevention of exacerbations - 0.25 G 3-4 times a day.

Meloxicam(movalis) - tablets 7.5 mg; rectal suppositories 15 each mg. It primarily inhibits COX-2, and therefore has a less pronounced ulcerogenic effect than other NSAIDs. Therapeutic dose for secondary inflammation in patients with arthrosis - 7.5 mg/day; for rheumatoid arthritis, use the maximum daily dose - 15 mg(in 2 doses).

Nabumethon(relafen) - tablets of 0.5 and 0.75 G. metabolized in the liver to form an active metabolite with a T1/2 of about 24 h. Highly effective for rheumatid arthritis. Prescribed once a day. in dose 1 G, if necessary - up to 2 G/day (in 2 doses). Side effects, in addition to those common to NSAIDs: the possibility of developing eosinophilic pneumonia, alveolitis, interstitial nephritis, non-feotic syndrome, hyperuricemia.

Naproxen(apo-naproxen, apranax, daprox, nalgesin, naprobene, naprosyn, noritis, pronaxen) - tablets of 125, 250, 275, 375, 500 and 550 mg; oral suspension (25 mg/ml) in bottles of 100 ml; rectal suppositories 250 and 500 mg. has a pronounced analgesic effect. Prescribed 250-550 mg 2 times a day; for an acute attack of gout, the first dose is 750 mg, then every 8 h 250-500 each mg for 2-3 days (until the attack stops), after which the dose is reduced.

Niflumic acid(donalgin) - capsules 0.25 G. For exacerbation of rheumatic diseases, 0.25 is prescribed G 3 times a day. (maximum 1 G/day), upon achieving improvement, the dose is reduced to 0.25-0.5 G/day For an acute attack of gout, the first dose is 0.5 G, in 2 h - 0,25 G and after 2 more h - 0,25 G.

Piroxicam(apo-piroxicam, Breksik-DT, movon, pirocam, remoxicam, roxicam, sanikam, felden, hotemin, erazon) - tablets and capsules of 10 and 20 mg; dissolvable tablets 20 each mg; 2% solution (20 mg/ml) for injection in ampoules of 1 and 2 ml; rectal suppositories 10 and 20 mg; 1% cream, 1% and 2% gel in tubes (for cutaneous use). After absorption, it penetrates well into the synovial fluid; T 1/2 from 30 to 86 h. Prescribed orally, intramuscularly and in suppositories 1 time per day. at a dose of 20-30 mg(maximum dose - 40 mg/day); during an acute attack of gout on the first day 40 mg once, in the next 4-6 days - 20 mg 2 times a day. (For long-term treatment gout drug is not recommended).

Sulindak(clinoril) - tablets 200 mg. Prescribed 2-3 times a day. The therapeutic dose is 400-600 mg/day

Tenoxicam(tenikam, tenoctil, tilcotil, tobitil) - tablets and capsules 20 each mg; rectal suppositories 10 each mg. Penetrates well into synovial fluid; T 1/2 60-75 h. Prescribed once a day. on average 20 mg. In case of an acute attack of gout, in the first two days the maximum daily dose is given - 40 mg. Special side effects: swelling around, visual disturbances; interstitial, glomerulonephritis, probable.

Phenylbutazone(butadione) - tablets of 50 and 150 mg, tablets 200 each mg; 20% solution for injection (200 mg/ml) in ampoules of 3 ml; 5% ointment in tubes. Prescribed orally at 150 mg 3-4 times a day. The ointment is applied in a thin layer (without rubbing) onto the skin over the affected joint or other affected area (for dermatitis, skin burns, insect bites, superficial thrombophlebitis etc.) 2-3 times a day. In case of deep thrombophlebitis, the drug is not used. other NSAIDs are more likely to develop aplastic and agranulocytosis.

Flurbiprofen(flugalin) - tablets of 50 and 100 mg, retard capsules 200 each mg; rectal suppositories 100 each mg. The therapeutic dose is 150-200 mg/day (in 3-4 doses), maximum daily dose 300 mg. Retard capsules are used once a day.

II Anti-inflammatory drugs

The ability to reduce inflammatory processes varies chemical structure. The most active hormones in this regard are the hormones of the adrenal cortex and their synthetic substitutes - the so-called glucocorticoids (prednisolone, dexamethasone, etc.), which, in addition, have a strong anti-allergic effect. During treatment with glucocorticoids, their side effects often occur: metabolic disorders, retention of sodium and water in the body and an increase in blood plasma volume, increased blood pressure, ulceration of the gastric mucosa and duodenum, immunosuppression, etc. With long-term use of glucocorticoids, the synthesis of natural hormones in the adrenal glands decreases, as a result of which, when taking these drugs, signs of insufficient function of the adrenal cortex may develop. In this regard, treatment with glucocorticoids should be carried out under constant medical supervision, using them without a doctor’s prescription is dangerous. also included in a number of ointments and suspensions (for example, prednisolone ointment, ointments “Ftorokort”, “Sinalar”, “Locacorten”, “Lorinden S”, “Celestoderm V”, etc.) used externally for inflammatory diseases of the skin and mucous membranes . You should also not use these dosage forms without a doctor’s prescription, because In this case, exacerbations of certain skin diseases and other serious complications may occur.

As a P. s. Some painkillers are used from among the so-called non-narcotic analgesics, for example acetylsalicylic acid, analgin, amidopyrine, butadione and drugs similar in properties (indomethacin, ibuprofen, ortofen, etc.). They are inferior to glucocorticoids in anti-inflammatory activity, but also have less pronounced side effects, which allows them to be widely used for the treatment of inflammatory diseases of the joints, muscles and internal organs.

A moderate anti-inflammatory effect is also exerted by (tannin, tanalbin, oak bark, romazulon, basic bismuth nitrate, dermatol, etc.), which are used mainly topically for inflammatory lesions of the skin and mucous membranes. Forming a protective film with protein substances of tissues, they protect mucous membranes and the affected surface from irritation and prevent further development inflammatory process.

For inflammatory processes of the gastrointestinal tract, especially in children, they are prescribed, for example, mucus from starch, flax seeds, rice water, etc.; they do not have an anti-inflammatory effect, but only protect the surface of the mucous membrane from irritation. Enveloping agents They are also used when prescribing medications that, in addition to their primary effect, also have an irritating effect.

The listed groups of drugs do not directly affect the cause of inflammation. In contrast, chemotherapeutic drugs - sulfonamide drugs, etc. - have specific anti-inflammatory properties, which are determined primarily by their ability to suppress the activity of certain microorganisms and prevent the development of inflammatory processes in infectious diseases. They are used for inflammatory processes of infectious origin only as prescribed by a doctor.

- lek. in VA, the overwhelming manifestations of inflammation. processes. Differences in chem. structure and mechanisms of action determine P.'s division with. for steroid and non-steroidal drugs. Steroid P. s. in chemistry structure belong to 11,17 dihydroxysteroids. Along with... ... Chemical encyclopedia


    • Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are new generation medications that have anti-inflammatory, antipyretic and analgesic effects. Their mechanism of action is based on blocking certain enzymes (cyclooxygenase, COX), which are responsible for the formation of prostaglandins - chemicals that promote pain, fever, and inflammation.

    The word “non-steroidal” in the name of these drugs indicates the fact that medications in this group are not artificial analogues of steroid hormones - powerful anti-inflammatory hormonal drugs. The most popular representatives of NSAIDs are diclofenac, ibuprofen.

    How NSAIDs work

    If analgesics are intended to combat pain, then NSAIDs reduce two unpleasant symptoms of the disease: inflammation and pain. Many drugs in this group are considered non-selective inhibitors of the cyclooxygenase enzyme, which suppress the effects of both of its isoforms (types) - COX-1 and COX-2.

    Cyclooxygenase is responsible for the formation of thromboxane and prostaglandins from arachidonic acid, which, in turn, is obtained from phospholipids cell membrane using the enzyme phospholipase A2. Among other functions, prostaglandins are regulators and mediators in the formation of inflammation.

    When are NSAIDs used?

    The most commonly used drugs are NSAIDs for the treatment of chronic or acute inflammation which are accompanied by pain. Anti-inflammatory non-steroidal drugs have gained great popularity due to effective treatment joints.

    We list the diseases for which these medications are prescribed:

    NSAIDs should not be used during erosive and ulcerative lesions of the gastrointestinal tract, especially at the stage of exacerbation, cytopenias, severe disorders of the kidneys and liver, pregnancy, individual intolerance. Should be prescribed with caution to patients with asthma, as well as to people who have previously had negative reactions while taking any other NSAIDs.

    Non-steroidal anti-inflammatory drugs: list of NSAIDs for the treatment of joints

    Let's look at the most effective and well-known NSAIDs, which are used to treat joints and other diseases when required. antipyretic and anti-inflammatory effect:

    Some medications are weaker, not so aggressive, some are designed for acute arthrosis, if emergency intervention is necessary in order to stop dangerous processes in the body.

    The main advantage of new generation NSAIDs

    Side effects are observed during prolonged use of NSAIDs (for example, during the treatment of osteochondrosis) and consist of damage to the intestinal and gastric mucosa with the formation of bleeding and ulcers. This disadvantage of non-selective NSAIDs was the reason for the creation of a new generation of drugs that block only COX-2 (an inflammatory enzyme) and do not affect the function of COX-1 (a defense enzyme).

    That is, new generation drugs have almost no ulcerogenic side effects (damage to the mucous membrane of the digestive system) associated with prolonged use of non-selective NSAIDs, but they increase the chance of thrombotic complications.

    The only disadvantage of the new generation of drugs is their high cost, which makes them inaccessible to most people.

    What are new generation NSAIDs?

    The new generation of anti-inflammatory non-steroidal drugs act much more selectively, they are more inhibit COX-2, and COX-1 remains almost unaffected. This is what can explain the rather high effectiveness of the drug in combination with a minimum of side effects.

    List of effective and popular anti-inflammatory drugs non-steroidal drugs new generation:

    • Xefocam. A medicine that is based on Lornoxicam. His characteristic feature is the fact that the drug has an increased ability to relieve pain. In terms of this indicator, it is similar to morphine, but at the same time it does not create addiction and does not have an opiate-like effect on the central nervous system.
    • Movalis. It has an antipyretic, well-defined anti-inflammatory and analgesic effect. The main advantage of this drug is that with constant medical supervision it can be used for quite a long time. Meloxicam is produced in the form of a solution for intramuscular injections, in ointments, suppositories and tablets. The tablets of the drug are quite convenient in that they have a long-lasting effect, and it is enough to use one tablet throughout the day.
    • Nimesulide. Successfully used to treat arthritis, vertebrogenic back pain, etc. Normalizes temperature, relieves hyperemia and inflammation. Taking the drug quickly leads to improved mobility and reduced pain. It is also used in the form of an ointment for application to the problem area.
    • Celecoxib. This drug significantly alleviates the patient’s condition with arthrosis, osteochondrosis and other diseases, effectively fights inflammation and perfectly relieves pain. Side effects on the digestive system from the drug are minimal or completely absent.

    In cases where long-term use of anti-inflammatory non-steroidal drugs is not necessary, then older generation drugs are used. However, sometimes this is simply a necessary measure, since not all people can afford a course of treatment with these drugs.

    Classification of NSAIDs

    Based on their chemical origin, these drugs come in non-acidic and acidic derivatives.

    Acidic preparations:

    Non-acidic drugs:

    • Sulfonamide derivatives;
    • Alcanons.

    At the same time, non-steroidal drugs differ in intensity and type of action - anti-inflammatory, analgesic, combined.

    According to the strength of the anti-inflammatory effect Medium doses of drugs are arranged in the following order (strongest on top):

    • Flurbiprofen;
    • Indomethacin;
    • Piroxicam;
    • Diclofenac sodium;
    • Naproxen;
    • Ketoprofen;
    • Aspirin;
    • Amidopyrine;
    • Ibuprofen.

    According to analgesic effect The drugs are arranged in the following order:

    Most often, the NSAIDs listed above are used for chronic and acute diseases which are accompanied by inflammation and pain. As a rule, non-steroidal anti-inflammatory drugs are used to treat joints and relieve pain: injuries, arthrosis, arthritis, etc.

    NSAIDs are often used for pain relief for migraines and headaches, renal colic, postoperative pain, dysmenorrhea, etc. Due to their inhibitory effect on prostaglandin synthesis, these drugs also have an antipyretic effect.

    Dosage selection

    Any medicine new to the patient should be prescribed at the beginning in a minimal dose. If tolerated normally, after a few days daily dose is increased.

    Therapeutic dosages of NSAIDs vary widely, with Lately There has been a trend towards increasing single and daily doses of drugs that are well tolerated (ibuprofen, naproxen), while maintaining restrictions on maximum dosage indomethacin, aspirin, piroxicam, phenylbutazone. In some patients therapeutic effect achieved only with the use of increased doses of NSAIDs.

    Side effects

    Long-term use of anti-inflammatory drugs in higher dosages can cause:

    Treatment with NSAIDs must be continued for the minimum possible time and minimum doses.

    Use during pregnancy

    It is undesirable to use NSAIDs during pregnancy, especially in the third trimester. Although no direct teratogenic effects are found, it is believed that NSAIDs can cause renal complications in the fetus and premature closure of the ductus arteriosus. There is also information about premature birth. Despite this, aspirin in combination with heparin has been used successfully in women with antiphospholipid syndrome.

    Description of non-steroidal anti-inflammatory drugs

    Movalis

    Is a leader among non-steroidal anti-inflammatory drugs, which has a long duration of action and is approved for long-term use.

    It has a pronounced anti-inflammatory effect, which makes it possible to use it for rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis. Protects cartilage tissue and is not without antipyretic and analgesic properties. Used for headaches and toothaches.

    The determination of doses and administration options (suppositories, injections, tablets) depends on the type and severity of the disease.

    Celecoxib

    A COX-2 inhibitor, which has a pronounced analgesic and anti-inflammatory effect. When used in therapeutic doses, it has almost no negative effect on the gastrointestinal mucosa, since it has a fairly low degree of affinity for COX-1 and, accordingly, does not cause disruption in the synthesis of constitutional prostaglandins.

    Indomethacin

    It is one of the most effective non-hormonal drugs. For arthritis, it reduces joint swelling, relieves pain and has a strong anti-inflammatory effect. When using a medication, you need to be careful, as it has a long list of side effects. In pharmacology, the drug is manufactured under the names Indovis EC, Indovazin, Indocollir, Indotard, Metindol.

    Ibuprofen

    It combines the ability to effectively reduce pain and temperature, and is relatively safe, which is why medications based on it can be purchased without a prescription. Ibuprofen is used as an antipyretic drug, including and for newborns.

    It is not used as often as an anti-inflammatory drug, but the medicine is very popular in rheumatology: it is used to treat osteoarthritis, rheumatoid arthritis and other joint diseases.

    The most popular names include Nurofen, Ibuprom, MIG 400 and 200.

    Diclofenac

    Form of manufacture - capsules, tablets, gel, suppositories, injection solution. This drug for the treatment of joints perfectly combines both a high anti-inflammatory effect and high analgesic activity.

    It is manufactured under the names Naklofen, Voltaren, Diklak, Ortofen, Vurdon, Diclonac P, Dolex, Olfen, Clodifen, Dikloberl, etc.

    Chondroprotectors - alternative drugs

    Very common for treating joints use chondroprotectors. People often do not understand the differences between chondroprotectors and NSAIDs. The latter quickly remove pain, but at the same time have many side effects. And chondroprotectors protect cartilage tissue, but they must be used in courses. The most effective chondroprotectors contain two substances - chondroitin and glucosamine.

    Anti-inflammatory non-steroidal drugs are excellent assistants during the treatment of many diseases. But we must not forget that they only remove the negatively affecting symptoms on well-being; the treatment of diseases themselves is carried out by other methods and drugs.

    For most infectious and inflammatory diseases respiratory system and ENT organs, non-steroidal anti-inflammatory drugs are widely used as symptomatic therapy. They are prescribed to lower fever, suppress inflammation and reduce painful sensations.

    Today there are more than 25 various medications, belonging to the group of non-steroidal anti-inflammatory drugs. Classification by chemical structure is considered to be of little use for comparative assessment of the effectiveness and safety of a drug. Of greatest interest are drugs that have a pronounced antipyretic and anti-inflammatory effect and have a low rate of adverse reactions.

    List of anti-inflammatory drugs that can be prescribed for diseases of the respiratory system and ENT organs:

    • Paracetamol.
    • Citramon.
    • Panadol Extra.
    • Coldrex.
    • TeraFlu.
    • Femizol.
    • Ferwerks.
    • Aspirin-S.
    • Ibuprofen.
    • Nise.
    • Nimesulide.

    Only the attending physician knows which anti-inflammatory tablets, capsules, powder, mixture or syrup will be effective in each specific case.

    Features of application

    All non-steroidal anti-inflammatory drugs have similar principles of action, the use of which leads to the elimination of the inflammatory process, fever and pain. In pulmonology and otolaryngology, preference is given to NSAIDs, which have more pronounced antipyretic and anti-inflammatory properties. I would like to note that due to high risk The occurrence of adverse reactions is highly undesirable when taking several NSAIDs at once. At the same time, their therapeutic effect does not increase, but the negative impact on the body, in particular on the digestive system, increases sharply.

    For serious problems with gastrointestinal tract(for example, peptic ulcer), it is better to use modern selective NSAID drugs of a new generation, which have a significantly lower likelihood of side effects. Despite the possibility of purchasing these medications without a prescription, the dosage and duration of the therapeutic course must be agreed with your doctor. During treatment, the consumption of alcoholic beverages should be avoided.

    Paracetamol


    With the main clinical symptoms Colds are effectively treated with Paracetamol. Taking it in the appropriate dosage makes it possible to quickly bring down a high fever, relieve malaise and fatigue, relieve pain, etc. The main advantages of the drug:

    • Recommended for use by the World Health Organization.
    • Fast antipyretic effect.
    • Quite well tolerated by most patients.
    • Low risk of adverse reactions.
    • Compared to other similar anti-inflammatory drugs, the cost is relatively low, which makes it accessible to all segments of the population.

    Paracetamol has its own characteristics of use. It can be used in the form of tablets, powder, rectal suppositories, injections, etc. Taking the drug orally or administering it rectally allows you to achieve more effective results. The interval between use should be at least 4 hours. Average duration treatment 5-7 days. A longer therapeutic course with this antipyretic drug is not recommended. Usually clinical manifestations Colds begin to subside on the 2-3rd day. If your condition worsens significantly, you should immediately consult a doctor.

    If the patient has an allergy to the components of the drug or severe problems with the kidneys and liver, Paracetamol should not be prescribed. The development of the following pathological conditions is classified as side effects:

    • Anemia.
    • Decreased platelet count.
    • Renal colic.
    • Glomerulonephritis.
    • Allergic manifestations (itching, redness of the skin, various rashes, etc.).

    In an attempt to achieve a quick result, some patients ignore the instructions outlined in the official instructions for use and take a dosage of an anti-inflammatory drug that exceeds the maximum recommended. In case of an overdose of Paracetamol, the following symptoms are possible:

    • The appearance of pallor, nausea, vomiting and pain in the abdominal area.
    • In case of failure to provide timely assistance and take too large dose medications affect the kidneys and liver. Arrhythmia, pancreatitis, and serious disorders of the central nervous system.

    If severe clinical manifestations of overdose are observed, it is necessary to prescribe Methionine or N-acetylcysteine, which are effective antidotes (antidote). In addition, when using Paracetamol, drug interactions with other drugs should be taken into account. For example, simultaneous use with indirect anticoagulants (coumarin derivatives) increases the effect of the latter. The antipyretic effect is significantly reduced when combined with barbiturates.

    A qualified specialist (pharmacist or doctor) will help you choose the best non-steroidal anti-inflammatory drug.

    Panadol Extra


    Panadol Extra is considered a combined NSAID drug, which contains not only paracetamol, but also caffeine as active substances. Both components enhance each other's effect. Paracetamol relieves pain and relieves fever. Caffeine has a stimulating effect on the central nervous system. In addition, by increasing the concentration of paracetamol in the brain by increasing the permeability of the blood-brain barrier, caffeine increases the analgesic effect of the drug.

    Panadol Extra helps relieve colds, acute tonsillitis, laryngopharyngitis and other infectious and inflammatory pathologies of the respiratory system and ENT organs. Most adults and children tolerate this anti-inflammatory drug quite well. As a rule, there are no special problems with the absorption and excretion of the medicine. Panadol Extra is not prescribed to patients who have hypersensitivity to the active substances. In rare cases, side effects occur, which may include:

    • Skachkov blood pressure.
    • Functional disorders of the liver.
    • Allergic reactions (redness, rashes, itching, etc.).

    For details of use and recommended dosage, please read the official instructions. It should only be noted that 8 tablets is the maximum that an adult patient can take per day. Considering pharmacological properties drug, the interval between doses should be at least 4 hours. Anti-inflammatory tablets Panadol Extra cost approximately 45 rubles per pack.

    Coldrex

    For acute infectious diseases the upper respiratory tract can be treated with Coldrex. This is a complex anti-inflammatory drug consisting of:

    • Paracetamol.
    • Caffeine.
    • Phenylephrine.
    • Terpinhydrate.
    • Ascorbic acid.

    Considering its multicomponent composition, Coldrex has a very diverse pharmacological effect:

    1. The presence of paracetamol normalizes the temperature, relieves pain and eliminates the inflammatory process.
    2. Ascorbic acid strengthens the local immunity of the respiratory tract.
    3. For narrowing peripheral vessels Phenylephrine is responsible for preventing the increase in edema of the affected tissues.
    4. Terpin hydrate enhances bronchial secretion and facilitates expectoration of sputum.
    5. Caffeine potentiates the analgesic effect of paracetamol.

    Coldrex has several varieties, each of which is selected individually, taking into account the severity clinical signs diseases. There are the following contraindications to its use:

    • Allergy to the active ingredients of the medicine.
    • Severe disorders of the liver and kidneys.
    • Diseases of the circulatory system.
    • High blood pressure.
    • Diabetes.
    • Cardiovascular pathology (for example, arrhythmias, heart attack, etc.).
    • Increased hormonal activity of the thyroid gland.
    • Children under 6 years of age.

    The therapeutic course should be no more than 5 days. The dosage and frequency of use are specified in detail in the official instructions. During treatment, drug interactions with other drugs must be taken into account. It is strictly not recommended to combine antidepressants, beta-blockers, etc. with medications from the group. Adverse reactions are rarely recorded. In general, the medicine is well tolerated. When used to treat children, it is better to first consult with your doctor. The cost of a package of Coldrex tablets ranges from 160 rubles.

    The list of NSAID drugs (tablets, capsules, etc.) is constantly updated and supplemented with new drugs that have more pronounced therapeutic effects and less toxic properties.

    Fervex

    Another representative of combined nonsteroidal anti-inflammatory drugs is Fervex, which today is successfully used for most colds of the upper respiratory tract. How the pharmacological effect of the drug is realized:

    • The analgesic and antipyretic effect is characteristic of paracetamol.
    • Strengthening local immunity and tissue restoration ensures ascorbic acid.
    • Pheniramine has an antihistamine effect, which helps reduce mucus production in the nasal cavity, improve breathing through the nose, eliminate sneezing, watery eyes, etc.

    Despite the fact that Fervex is considered quite safe medicine, not all patients can use it. At the next pathological conditions and diseases you cannot use this medicinal product:

    • Allergies to the active ingredients (paracetamol, ascorbic acid and pheniramine).
    • Serious problems with digestive system(for example, peptic ulcer).
    • Severe renal impairment.
    • Portal hypertension.
    • Alcoholism.
    • Glucose-6-phosphate dehydrogenase deficiency.
    • Pregnancy and breastfeeding.

    Children can use Fervex starting from the age of 15. Use with extreme caution when:

    • Functional liver failure.
    • Angle-closure glaucoma.
    • Congenital disorders of bilirubin metabolism (for example, Gilbert's syndrome).
    • Viral hepatitis.
    • In old age.

    At the recommended dosage, the drug is well tolerated. However, nausea, pain in the abdomen, itching, redness of the skin, rashes and other allergic reactions may occur. Unjustified prolonged use or significantly exceeding the recommended dosage increases the risk of developing serious problems with the kidneys and liver. If side effects occur, stop taking the medicine and consult a specialist for professional medical help.

    The anti-inflammatory drug has its own characteristics of use. The contents of the Fervex sachet are dissolved in warm water (200 ml) and drunk completely. The recommended dosage is up to three times a day. The next appointment should be no earlier than 4 hours later. In case of functional disorders of the kidneys and liver, increase the interval between applications to 8 hours. The therapeutic course is up to five days. Can be used for 3 days to reduce fever. The French company UPSA produces powder for oral administration of Fervex. You can purchase it at a price of 360 rubles per package, which contains 8 sachets.

    A complete list of modern anti-inflammatory drugs can be found in the pharmaceutical reference book.

    Aspirin-S


    Today, one of the most popular medicines for symptomatic treatment Infectious and inflammatory diseases of the respiratory system are considered Aspirin-S. Containing acetylsalicylic and ascorbic acids, it is able to effectively eliminate the main clinical manifestations of colds (fever, headaches, malaise, etc.). The effectiveness of the medicine has been proven by numerous scientific studies.

    Aspirin-S is available in the form of effervescent tablets that can be quickly dissolved in water. This form is very convenient for most patients with colds. Especially with severe sore throat, when the use of ordinary tablets or hot drinks provokes a very unpleasant sensation. In addition, it has long been established that ascorbic acid is destroyed when high temperature. By dissolving it in cool water, we preserve all the pharmacological properties of vitamin C. The absorption of the medicine occurs quite quickly, which ensures the immediate onset of the therapeutic effect. It is also worth noting that acetylsalicylic acid is completely soluble in water without the formation of sediment, reducing the likelihood of various side effects.

    However, uncontrolled long-term use of the drug can lead to the development of a number of undesirable effects:

    • Dizziness.
    • Headaches.
    • Nausea.
    • Vomiting.
    • Breathing problems.
    • Drowsiness.
    • Lethargy.
    • Increased bleeding.
    • Allergies (itching, rashes, redness of the skin, etc.).

    In case of an overdose of Aspirin-S, it is necessary to control the acid-base balance in the body. If necessary, special solutions are introduced to normalize the condition (for example, sodium bicarbonate or citrate). Undertakings therapeutic measures should be aimed at enhancing the excretion of acetylsalicylic acid and its metabolites.

    It should be noted that in children with suspected viral infection do not use medications that contain acetylsalicylic acid, since the likelihood of developing a more severe pathology, such as Reye's syndrome, increases. It manifests itself with prolonged vomiting, damage to the central nervous system and enlarged liver.

    Before surgery, it is better to refrain from taking Aspirin-S, which affects the blood coagulation system. Also, acetylsalicylic acid slows down the process of removing uric acid from the body. Patients suffering from gout may experience another attack while being treated with this drug. Aspirin-S is a prohibited drug during pregnancy. On early stages often provokes birth defects development in the fetus, in later stages it inhibits labor.

    The Swiss pharmaceutical company Bayer Consumer Care AG is one of the main manufacturers of Aspirin-S effervescent tablets. The cost of a package of medicine (10 pieces) is approximately 250 rubles.

    Ibuprofen

    Complex therapy for infectious and inflammatory diseases of the respiratory system and ENT organs may include Ibuprofen. It is now considered one of the most commonly prescribed non-steroidal anti-inflammatory drugs for the management of fever and pain. Widely used not only in therapeutic but also pediatric practice. Being a very safe and effective antipyretic drug, it is approved for sale without a doctor's prescription.

    If there are appropriate indications, it can be used to treat children from the first days of life both in inpatient and laboratory conditions. Children are recommended to use Ibuprofen in the form of rectal suppositories, which have a number of advantages compared to other forms of medication:

    • Simplicity and painlessness of administration.
    • There is no need for additional special tools.
    • The integrity of the skin is not compromised.
    • There is no danger of infection.
    • Intestinal fullness does not affect the absorption and effectiveness of the drug.
    • Low incidence of allergic reactions.

    Most patients do not experience any side effects during treatment with Ibuprofen. However, in rare cases, undesirable effects are still possible, which manifest themselves in the form of:

    • Decreased appetite.
    • Nausea.
    • Vomiting.
    • Headache.
    • Drowsiness.
    • Nervousness.
    • Hearing and vision impairments.
    • Increased blood pressure.
    • Increased heart rate.
    • Difficulty breathing.
    • Edema syndrome.
    • Kidney disorders.
    • Allergies (rashes, itching, redness of the skin, Quincke's edema, etc.).

    It is worth noting that the list of contraindications for the use of Ibuprofen is quite long, so we recommend that you read it in the official instructions for the drug. During therapy, it is advisable to use the minimum effective dosage of a non-steroidal anti-inflammatory drug to reduce the risk of adverse reactions. It is also preferable to stick to short courses of treatment. If the drug is ineffective or the condition worsens, you should immediately visit your doctor. Special attention attention should be paid to the state of the digestive system, which is very sensitive to therapy non-steroidal drugs. Today, Ibuprofen is available under various trade names:

    • Ibufen.
    • Nurofen.
    • Advil.
    • Faspik.
    • Yprene.

    These drugs are produced both foreign and domestic pharmaceutical companies. The cost of the medicine will depend not only on the form of release, but also on the amount of the active substance. For example, a package of Ibuprofen tablets from the Russian pharmaceutical company Sintez costs about 40 rubles.

    Non-steroidal anti-inflammatory drugs are available without a prescription, but this does not mean that you should not consult a specialist before using them.

    Nise

    Some doctors may recommend the drug Nise for infectious and inflammatory diseases of the upper and lower respiratory tract, which are accompanied by fever and pain. This modern non-steroidal anti-inflammatory drug contains the active substance nimesulide. It must be taken when the symptoms of the disease are severe. For example, Nise is able to bring down the temperature in 10-12 hours. He can also relieve headaches, fatigue, weakness, malaise, aching muscles and joints. However, if there is no sufficient therapeutic effect within 3-4 days, you should visit your doctor and adjust the course of treatment.

    During the period of bearing a baby, the drug should absolutely not be used. It has been established that nimesulide has a negative effect on the growth and development of the fetus. In addition, the active substance can pass into breast milk, so during treatment it is necessary to switch to artificial feeding. If all recommendations for the use of the medicine specified in the instructions are correctly followed, adverse reactions are practically not observed. In rare cases, the following may occur:

    • Nausea, vomiting, diarrhea and other dyspeptic disorders.
    • Headache, drowsiness, irritability.
    • Increased blood pressure, breathing problems.
    • Changes in basic blood parameters (for example, anemia, decreased platelet count, etc.).
    • Reversible functional problems with the functioning of the kidneys and liver.
    • Rash, itching, erythema, redness of the skin and other allergic reactions.

    Nise should be taken with extreme caution by patients who have problems with the digestive system, in particular peptic ulcers. It is recommended to use short therapeutic courses, which in most cases successfully cope with the main symptoms of colds. Foreign pharmaceutical companies mainly specialize in the production of Nise, so the price will often be slightly higher compared to domestic analogues of the drug. A package of tablets (20 pcs.) made in India will cost approximately 180 rubles.

    When choosing an effective non-steroidal anti-inflammatory drug, never neglect the opinion of a specialist.

    There is practically no disease for which non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) would not be used. This is a huge class of tablets, injections and ointments, the ancestor of which is ordinary Aspirin. The most common indications for their use are joint diseases accompanied by pain and inflammation. In our pharmacies, both long-tested, well-known drugs and new generation anti-inflammatory non-steroidal drugs are popular.

    The era of such drugs began quite a long time ago - in 1829, when salicylic acid was first discovered. Since then, new substances began to appear and dosage forms, capable of eliminating inflammation and pain.

    With the creation of Aspirin, NSAID drugs were classified as a separate group of non-steroidal anti-inflammatory drugs. Their name determines that they do not contain hormones (steroids) and have fewer side effects than steroid ones.

    Despite the fact that in our country most NSAIDs can be bought in pharmacies without a prescription, there are some points that you need to know about. Especially for those people who are wondering what is better to choose – drugs that have been offered for years, or modern NSAIDs.

    The principle of action of NSAIDs is the effect on the enzyme cyclooxygenase (COX), namely its two varieties:

    1. COX-1 is a protective enzyme in the gastric mucosa, protecting it from acidic contents.
    2. COX-2 is an inducible, that is, a synthesized enzyme that is produced in response to inflammation or damage. Thanks to it, the inflammatory process plays out in the body.

    Since first-generation non-steroids are non-selective, that is, they act on both COX-1 and COX-2, then along with the anti-inflammatory effect, they also have strong side effects. It is important to take these tablets after meals, as they are irritating to the stomach and can lead to erosions and ulcers. If you already have stomach ulcers, you need to take them with proton pump inhibitors (Omeprazole, Nexium, Controloc, etc.), which protect the stomach.

    Time does not stand still, non-steroids are developing and becoming more selective for COX-2. Now on this moment There are drugs that selectively act on the enzyme COX-2, which affects inflammation, without affecting COX-1, that is, without damaging the gastric mucosa.

    About a quarter of a century ago there were only eight groups of NSAIDs, but today there are more than fifteen. Having gained widespread popularity, non-steroidal tablets quickly replaced the opioid painkillers of the analgesics group.

    Today, there are two generations of non-steroidal anti-inflammatory drugs. The first generation is NSAID drugs, most of them non-selective.

    These include:

    • Aspirin;
    • Citramon;
    • Naproxen;
    • Voltaren;
    • Nurofen;
    • Butadion and many others.

    New generation non-steroidal anti-inflammatory drugs are safer in terms of side effects, and they have a greater ability to relieve pain.

    These are selective non-steroids such as:

    • Nimesil;
    • Nise;
    • Nimesulide;
    • Celebrex;
    • Indomethaxin.

    This is far from full list and not the only classification of new generation NSAIDs. There is a division into non-acidic and acidic derivatives.

    Among NSAIDs latest generation the most innovative drugs are oxicams. These are non-steroidal anti-inflammatory drugs of a new generation of the acid group, which affect the body much longer and more clearly than others.

    This includes:

    • Lornoxicam;
    • Piroxicam;
    • Meloxicam;
    • Tenoxicam.

    The acid group of drugs also includes the following series of non-steroids:

    Non-acid drugs, that is, those that do not affect the gastric mucosa, include new generation NSAIDs of the sulfonamide group. Representatives of this group are Nimesulide, Rofecoxib, Celecoxib.

    New generation NSAIDs have gained widespread use and popularity due to their ability not only to relieve pain, but also to have an excellent antipyretic effect. The drugs stop the inflammatory process and prevent the disease from developing, so they are prescribed for:

    • Diseases of musculoskeletal tissue. Nonsteroids are used to treat injuries, wounds, and bruises. They are indispensable for arthrosis, arthritis and other diseases of a rheumatic nature. Also, for herniated intervertebral discs and myositis, the drugs have an anti-inflammatory effect.
    • Severe pain syndromes. They are successfully used in the postoperative period, for biliary and renal colic. The tablets have a positive effect on headaches and gynecological pain, and successfully relieve pain from migraines.
    • Risk of blood clots. Since nonsteroids are antiplatelet, that is, they thin the blood, they are prescribed for ischemia and for the prevention of strokes and heart attacks.
    • High temperature. These tablets and injections are the primary antipyretic for adults and children. They are recommended for use even in feverish conditions.

    The drugs are also used for gout and intestinal obstruction. In case of bronchial asthma, it is not recommended to use NVPP on its own; prior consultation with a doctor is necessary.

    Unlike non-selective anti-inflammatory drugs, new generation NSAIDs do not irritate the body’s gastrointestinal system. Their use in the presence of gastric and duodenal ulcers does not lead to exacerbation and bleeding.

    However, their long-term use can cause a number of unwanted effects, such as:

    • increased fatigue;
    • dizziness;
    • dyspnea;
    • drowsiness;
    • destabilization of blood pressure.
    • the appearance of protein in the urine;
    • indigestion;

    Also, with long-term use, allergies may occur, even if previously there was no susceptibility to any substances.

    Non-selective non-steroids such as Ibuprofen, Paracetamol or Diclofenac have greater hepatotoxicity. They have a very strong effect on the liver, especially Paracetamol.

    In Europe, where all NSAIDs are prescription drugs, over-the-counter Paracetamol is widely used (taken as a pain reliever up to 6 tablets per day). There appeared such a medical concept as “paracetamol liver damage,” that is, cirrhosis while taking this medicine.

    Several years ago, a scandal broke out abroad regarding the influence of modern nonsteroids, coxibs, on the cardiovascular system. But our scientists did not share the concerns of their foreign colleagues. The Russian Association of Rheumatologists acted as an opponent to Western cardiologists and proved that the risk of cardiac complications while taking new generation NSAIDs is minimal.

    Most anti-inflammatory non-steroids should absolutely not be used during pregnancy, especially in the third trimester. Some of them can be prescribed by a doctor in the first half of pregnancy for special indications

    By analogy with antibiotics, new generation NSAIDs should not be taken in too short courses (drink for 2-3 days and stop). This will be harmful, because in the case of antibiotics, the temperature will go away, but the pathological flora will acquire resistance (resistance). The same is with non-steroids - you need to take them for at least 5-7 days, since the pain may go away, but this does not mean that the person has recovered. The anti-inflammatory effect occurs a little later than the anesthetic and proceeds more slowly.

    1. Under no circumstances should you combine non-steroids from different groups. If you take one tablet for pain in the morning and then another, their beneficial effects do not add up and are not enhanced. And side effects increase exponentially. Especially you should not combine cardiac Aspirin (Aspirin-Cardio, Cardiomagnyl) and other NSAIDs. In this situation, there is a danger of a heart attack, since the effect of aspirin, which thins the blood, is blocked.
    2. If any joint hurts, it is better to start with ointments, for example, based on ibuprofen. They should be applied 3-4 times a day, especially at night, and rubbed intensively into sore spot. You can use the ointment to self-massage the sore spot.

    The main condition is peace. If you continue to actively work or play sports during treatment, the effect of using the medications will be very small.

    The best drugs

    Coming to the pharmacy, every person thinks about which non-steroidal anti-inflammatory drugs to choose, especially if he came without a doctor’s prescription. The choice is huge - non-steroids are available in ampoules, tablets, capsules, ointments and gels.

    Tablets that are derivatives of acids have the greatest anti-inflammatory effect.

    The following have a good analgesic effect in diseases of the musculoskeletal tissue:

    • Ketoprofen;
    • Voltaren or Diclofenac;
    • Indomethacin;
    • Xefocam or Lornoxicam.

    But the most strong remedies against pain and inflammation - these are the newest selective NSAIDs - coxibs, which have the lowest side effects. The best non-steroidal anti-inflammatory drugs in this series are Arcoxia, Nise, Movalis, Celecoxib, Xefocam, Etoricoxib.

    Xefocam

    Analogues of the drug are Lornoxicam, Rapid. The active ingredient is xefocam. An effective medicine with a pronounced anti-inflammatory effect. Does not affect heart rate, blood pressure and respiratory rate.

    Available in the form:

    • tablets;
    • injections.

    For elderly patients, no special dosage is required in the absence of renal failure. In case of kidney disease, the dose must be reduced, since the substance is excreted by these organs.

    With excessive duration of treatment, manifestations in the form of conjunctivitis, rhinitis and shortness of breath are possible. For asthma, use with caution, as an allergic reaction in the form of bronchospasm is possible. When the injection is administered intramuscularly, pain and hyperemia at the injection site are possible.

    The drug Arcoxia or its only analogue Exinev are drugs used for acute gouty arthritis, osteoarthritis of the rheumatoid type, and in the treatment of postoperative conditions associated with pain. Available in the form of tablets for oral use.

    The active ingredient of this drug is etoricoxib, which is the most modern and safe substance among the selective COX-2 inhibitors. The product perfectly relieves pain and begins to act on the source of pain within 20-25 minutes. Active substance The medicine is absorbed into the bloodstream and has high bioavailability (100%). It is excreted unchanged in the urine.

    Nimesulide

    Most sports traumatology specialists identify a non-steroid such as Nise or its analogues Nimesil or Nimulid. There are many names, but active substance They have one thing - nimesulide. This medicine is quite cheap and occupies one of the first places in sales.

    This is a good pain reliever, but Nimesulide-based products should not be used by children under 12 years of age, as there is a high risk of allergic reactions.

    Available in:

    • powders;
    • suspensions;
    • gels;
    • tablets.

    It is used in the treatment of arthritis, arthrosis, ankylosing spondylitis, sinusitis, lumbago, and pain of various localizations.

    Movalis is much more selective for COX-2 than Nise, and accordingly has even fewer side effects in relation to the stomach.

    Release form:

    • candles;
    • pills;
    • injections.

    With long-term use, the risk of developing cardiac thrombosis, heart attacks, and angina is increased. Therefore, people with a predisposition to these diseases need to be careful in use. It is also not recommended for women planning pregnancy as it affects fertility. It is excreted in the form of metabolites, mainly in urine and feces.

    Celecoxib

    In the group with the most proven safety base is the new generation NSAID Celecoxib. This was the first drug from the group of selective coxibs, combining the three strengths of this class - the ability to reduce pain, inflammation, and fairly high safety. Release form: capsules of 100 and 200 mg.

    The active component celecoxib selectively acts on COX-2 without affecting the gastric mucosa. Quickly absorbed into the blood, the substance reaches its highest concentration after 3 hours, but simultaneous administration with fatty foods may slow down the absorption of the medicine.

    Celecoxib is prescribed for soriatic and rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. This drug is not prescribed for liver and kidney failure.

    Rofecoxib

    The main substance rofecoxib effectively helps restore motor function of joints, quickly relieving inflammation.

    Available in:

    • injection solutions;
    • tablets;
    • candles;
    • gel.

    The substance is a highly selective inhibitor of cyclooxygenase 2, which is quickly absorbed by the gastrointestinal tract after administration. The substance reaches its maximum concentration in the blood after 2 hours. It is excreted primarily in the form of inactive metabolites by the kidneys and intestines.

    The result of long-term use may be disorders of the nervous system - sleep disorders, dizziness, confusion. It is recommended to start treatment with injections, then switch to tablets and external agents.

    When choosing any NSAIDs, you should be guided not only by price and their modernity, but also take into account the fact that all such drugs have their contraindications. Therefore, you should not self-medicate; it is best if they are prescribed by a doctor, taking into account age and history of diseases. It should be remembered that thoughtless use of medications may not only not bring relief, but will also force a person to treat many complications.

    Non-steroidal anti-inflammatory drugs (NSAIDs, NSAIDs) are drugs that have analgesic, antipyretic and anti-inflammatory effects.

    The mechanism of their action is based on blocking certain enzymes (COX, cyclooxygenase), they are responsible for the production of prostaglandins - chemicals that promote inflammation, fever, pain.

    The word “non-steroidal”, which is contained in the name of the group of drugs, emphasizes the fact that the drugs in this group are not synthetic analogues of steroid hormones - powerful hormonal anti-inflammatory drugs.

    The most famous representatives of NSAIDs: aspirin, ibuprofen, diclofenac.

    How do NSAIDs work?

    While analgesics directly combat pain, NSAIDs reduce both of the most unpleasant symptoms of the disease: pain and inflammation. Most drugs in this group are non-selective inhibitors of the cyclooxygenase enzyme, suppressing the action of both of its isoforms (varieties) - COX-1 and COX-2.

    Cyclooxygenase is responsible for the production of prostaglandins and thromboxane from arachidonic acid, which in turn is obtained from cell membrane phospholipids by the enzyme phospholipase A2. Prostaglandins, among other functions, are mediators and regulators in the development of inflammation. This mechanism was discovered by John Wayne, who later received Nobel Prize for his discovery.

    When are these drugs prescribed?

    Typically, NSAIDs are used to treat acute or chronic inflammation accompanied by pain. Non-steroidal anti-inflammatory drugs have gained particular popularity for the treatment of joints.

    Let us list the diseases in which these drugs are prescribed:

    • (menstrual pain);
    • bone pain caused by metastases;
    • postoperative pain;
    • fever (increased body temperature);
    • intestinal obstruction;
    • renal colic;
    • moderate pain due to inflammation or soft tissue injury;
    • lower back pain;
    • pain when


    New on the site

    >

    Most popular

    © 2024. Dental consultation portal.

    POPULAR SECTIONS